LAUSR

Biliary complications are still a major problem in liver transplantation despite advances in surgical techniques and accumulating experience. Historically, Roux-en-y (RY) biliary reconstruction has been the procedure of choice for pediatric patients due to the high prevalence of biliary atresia and technical challenges related to the small size and fragility of the ducts of pediatric recipients. On the other hand, there are some suggested advantages of duct-to-duct (DD) biliary reconstruction, such as providing a better bacterial barrier and facilitating postoperative endoscopic access by preserving anatomic continuity. Although there are articles on the feasibility of DD biliary reconstruction in pediatric liver transplantation, most of these studies cover living donor pediatric liver transplantations, and there is no study covering DD reconstruction in pediatric split-liver transplantations (SLTs). This study aims to represent 5 pediatric SLT recipients with DD reconstruction and discusses its feasibility over the outcomes of these patients with a brief review of the literature. Patients and Methods